A Brief Review of Probiotic Use

Probiotic therapy refers to use of live microorganisms to treat human pathological disorders such as lactose intolerance and antibiotic induced superinfections. The critical point to be consideted is whether such administered microorganisms can remain viable and multiply in the gastrointestinal tract given that their nutrient and environmental condition requirements are very exacting. In this brief review, the authors discuss the use of probiotics from a historical perspective and conclude that their use especially in form of traditional fermented food products can be justifiedthe controversy notwithstanding

Smallholder Rural Youth Farming in Kiambu County, Kenya

Investment on agriculture by countries is essential because it is core to every nation’s development. In Kenya, people particularly youth are involved in agriculture yet it attracts limited investment. This study which was aimed at highlighting age, gender participation and the role of literacy in small scale farming among the trained youth in Kiambu County, Kenya. This was mixed methods descriptive and cross sectional study that also employed triangulation to enhance confidence in the findings. This design underscored the current socio-demographic benefits to rural youth small scale farmers in Kabete constituency, Kiambu County, Kenya. Kabete Constituency, was non-probabilistic and purposively selected due to limited time and resources, its cosmopolitan, high agricultural potential comprising both subsistence and commercial farmers and easily accessible to the Nairobi city which is a high potential market for agricultural produce. The study was conducted over a five-month period from September 2015 to January 2016. The study population comprised trained agri-business young rural farmers aged 21 to 35 years who farmed on no more than 0.75 acres of land resident in Kabete Constituency. The key informants who were old farmers and a sample of 111 youths who had practiced farming for more than five years were sampled purposively and using simple random design, respectively. Parents were conveniently sampled for the interviews and focus group discussions (FGD) were conducted in two selected locations. The relevant data was solicited through the use of questionnaire, focus group discussions and observation on youth smallholder trends and farm management practices especially during the data collection period. The instruments were pretested and scrutinized for validity and reliability. Quantitative data was analyzed on descriptive statistics using Statistical Package for Social Sciences (SPSS) version 21.0 while qualitative data was analyzed thematically using content analysis. This study showed that a large majority (53%) of the trained youthful rural farmers had attained at least form four level of education compared to 40% of them who had college or University levels of education. Only (15%) had primary school level of education and only 4% of the youthful farmers had no formal education. These findings confirmed that guaranteed literacy among trained rural youthful famers in Kiambu County, Kenya was high (93%), an indicator for the likelihood of effective and successful farming. Over two-thirds (67.4%) of the rural youthful small-scale farmers in Kabete Constituency in Kiambu County, Kenya, has access to financial credit services compared 26.7% who did not have access and 5.9% who had not made up their mind about access to credit services. The rural youthful farmers had above average access to credit services in the study area, further the study established that slightly less than half (46.5%) of the farmers accessed their capital from their families through inheritance, 36% made savings and 17.5% accessed loans. Post-harvest challenge was the most prone challenge among youth framers and smallholder farming in Kabete constituency had improved lives of youths. To concluded, smallholder farming was offering a wide potential for rural youths by creating employment, encouraging savings, reducing food expenses and encouraged self-reliance among the youth. The study recommended review of agricultural policies that will accommodate the youth’s representation and protection of environment that supports farm. Also recommended is adoption of ICT in agricultural practice in Kenya. Keywords: Agriculture, youth, participation, stakeholders, environment

FACTORIAL STRUCTURE OF ROSENBERG’S SELF-ESTEEM SCALE AMONG INJURED MALE RUGBY PLAYERS IN THE KENYA CUP COMPETITION

Four different confirmatory factor analysis (CFA) models, including CFAs with correlated traits, uniqueness’s, and methods, were employed to test the factorial structure of Rosenberg’s (1965) self-esteem scale in a sample of injured male rugby players in the Kenya cup competition. The outcome of the factorial analysis to some extent concurs with studies conducted earlier. These finding depict that (a) there exists a single global self-esteem factor underlying responses to Rosenberg scale; (b) method effects associated with item wording exist; and (c) the method effects were associated primarily with positively, rather than negatively, worded items. The sample consisted of 105 injured male rugby players the average age was 21.7±5.3 years, and the majority 23.8% were 20 years old. Majority 67.6% (n=71) of the respondents were forwards, while 32.4% (n=34) were backs. 82.9% were not capped with the national team while 11.4% (n=12) weighed 70kgs. The research hypothesized a four-factor structure of the RSES utilizing CFA with the SPSS-AMOS 16. The first model outcome was, (X2=132.2 df=35 CFI=0.561 NFI=0.463 RMSEA=0.163 SRMR=0.1373 AIC=192.2. The second model (X2=77.609 df=27 CFI=0.748 NFI=0.685 RMSEA=0.134 SRMR=0.1197 AIC=153.609). The third model was a Uni-dimensional positive wording X2=58.378 df=25 CFI=0.834 NFI=0.763 RMSEA=0.113 SRMR=0.0888 AIC=138.378. Finally, a model was run on Positive and Negative wording correlated, the outcomes (X2=79.68 df=34 CFI=0.748 NFI=0.685 RMSEA=0.114 SRMR=0.1151 AIC=121.68). Every model, including the single-factor model (Model 1), fits data adequately. However, the function of a single theoretical dimension (GSE) was contaminated by method effects. Our results show that method effects need to be taken into account to obtain a close model fit (i.e., RMSEA < 0.05). Article visualizations

Experience of Nursing Students in Mental Health Training in Kenya

Introduction: In Kenya, there are few psychiatric nurses available to provide mental health services. Few students pursue psychiatric nursing specialty.Objective: The aim of this study was to investigate the factors affecting psychiatric clinical experience of students of nursing during mental health nursing placement and its influence on the choice of psychiatric nursing specialty training.Methods: A descriptive cross sectional study was conducted with a sample size of 241 participants was carried out in 3 universities and 6 diploma training colleges in Kenya. Cluster and systematic random sampling was used to select the study participants. Statistical significance was set at p≤0.05.Results: Based on two-sided t-test, a significant relationship existed between value of mental health and willingness to pursue psychiatric nursing. Students who liked psychiatric nursing had a higher mean in the domain of value of mental health with a mean of 4.8 (95% CI= 4.7-4.9) unlike their counterparts with a mean of 4.5 (95% CI=4.4-4.6); p&lt;0.0001. A significant relationship between the willingness to pursue mental health and preparation for mental health clinical placement existed. Students who had a valuable experience were willing to pursue mental health and they had a higher mean of 2.9 (95% CI = 2.9-3.0, p&lt;0.0001).Conclusion: The findings from this study show that psychiatric experience of students influences the desire of a student to pursue the specialty. All people responsible with the training of students should ensure that the students have a pleasant psychiatric experience

Experience with UIDC insertion outside of menses in Kenya

Objective: To determine if women receiving intrauterine devices (IUCDs) outside of menses have an acceptable rate of insertion problems and subsequent IUCD-related complications.Design: Cross-sectional and prospective cohort study of insertions at times other than during menses.Setting: The study was carried out in two government family planning (FP) clinics in Nairobi,Kenya.Subjects: After appropriate pre-test and post-test HIV counselling, 1686 women requesting IUCDs at two FP clinics between 1994 and 1995 in Nairobi were enrolled at baseline into a study examining the effect of human complications. Six hundred and forty nine women (156 HIV-infected and 493 HIVuninfected) were selected for the four month follow up study. They were classified according to their menstrual cycle status at time of IUCD insertion.Main outcome measures: Problems at the time of insertion (pain, bleeding, immediate expulsion) and IUCD-related complications through four months.Results: Rates of immediate insertion problems were low in the women who had insertions during menses (7.0%), outside of menses (4.0%) or had oligomenorrhea/amenorrhea (2.6%). The adjusted odds ratios for IUCD insertion problems outside of menses and in oligomenorrhea/amenorrhea (versus women with insertion during menses) were 0.54 (95% CI 0.18 -1.59) and 0.39 (95% CI 0.12 -1.29) respectively. IUCD-related complications were higher in the iligomenorrhea/amenorrhea (11.5%) or insertion outside of menses (6.9%), than the within menses (4.3%) groups. However, the differences were not statistically significant. Adjusted odds ratios for IUCD outside of menses and oligomenorrhoea/amenorrhea groups were 1.65 (95% CI 0.21 - 12.91) and 2.72 (95% CI 0.34 - 21.71) respectively.Conclusion: The results confirm that the IUCD can be safely inserted outside of menses with minimal insertion difficulties and subsequent complications. Availability of IUCDs outside of menses may enhance IUCD acceptance in Kenya and create better opportunity for visualscreening of the cervix for sexually transmitted infections

Outcome of a working diagnosis of \"psychosis\" in relation to DSM-IV diagnostic criteria in a Kenyan in-patient cohort at Mathari hospital, Nairobi

Background: When a patient presents with mental illness and displays psychotic symptoms which are not clearly delineated, a clinical diagnosis of psychosis is usually entertained. Aim: To determine the underlying Diagnostic and Statistical Manual of Mental Disorders-Fourth edition (DSM-IV) disorders in clinical entities admitted with a working diagnosis of \"psychosis\" at Mathari Psychiatric Hospital, Nairobi, Kenya. Study Design: Descriptive cross-sectional quantitative study Method: A total of 138 patients with a working diagnosis of \"psychosis\" on admission at Mathari Hospital during the period of this study were recruited over a one-month period. Their DSM-IV diagnoses were made using the Structured Clinical Interview for DSM-IV (SCID). Analysis of the results was done using SPSS version 11.5. Results: Nearly three quarters (72.5%) of the patients were male, 68.5% were aged between 20 and 34 years and 63.7% reported that they were single. Nearly half (49.2%) had attained up to 12 years of formal education and 90% were dependants of a member of the family. The most common DSM-IV diagnoses were schizophrenia, bipolar disorder, substance abuse, depression and anxiety disorders. Co-morbidity was recorded with an average of three DSM-IV disorders. Conclusion: \"Psychosis\" as a working diagnosis was reported in relatively young adults. The patients whose working clinical diagnosis was \"psychosis\" met the criteria for an average of three DSM-IV diagnoses. There is need for a proactive policy in clinical practice so that definitive diagnoses rather than just \"psychosis\" are made and appropriate management initiated as early as possible. African Health Sciences Vol. 7 (4) 2007: pp. 197-20

Perceived economic and behavioural effects of the mentally ill on their relatives in Kenya: a case study of the Mathari Hospital

Objective: There is no documented evidence in Kenya on relatives’ perceptions of economic and behavioural effects of the mentallyill patients and their coping mechanisms. To document what relatives of mentally ill patients perceive to be the economic effects of the patients on the family and how they are affected by and cope with the disturbed behaviours of the patients. Method: This was a cross-sectional descriptive study conducted at the Mathari Psychiatric Hospital. Informed consent was obtained from both the relatives and the patients admitted at the hospital. Data on socio-demographic and economic profiles were obtained from thepatients and their relatives. The relatives were interviewed using a structured questionnaire to determine what they perceived to be the economic effects of the mental illness, how the various disturbed behaviours of the mentally ill affected them, and how they coped. The data were analysed using SPSS version 11.5 and results are presented in narratives and tables. Results: One hundred and seventy-five relatives and 107 patients were recruited and interviewed. The patients were younger and better educated but economically less well off than their relatives. The relatives perceived that the mentally ill patients caused financial constraints and that various disturbed behaviours, particularly, verbal and physical aggression and refusal of the patient to take medicine or go to hospital, affected the family in different ways. Different coping mechanisms were used, depending on whether or not the behaviours were intrusive. Conclusion: Mentally ill patients adversely affect their families in diverse ways. There is need for appropriate policy to address the needs of families with mentally ill patients at the family and community levels. However, these must be evidence-based and this calls for further research.Key words: Mental illness; Caregivers; Keny

A study of drug use in five urban centres in Kenya

Few studies have addressed the reasons for substance use in Kenya, with most focusing on prevalence rates in school-based and general population samples. None have been carried out among people already using drugs. This study, based on five samples of drug users, aimed to identify patterns of factors contributing to and consequences of substance use; compare socio-demographic characteristics; document help-seeking behaviours of substance abusers as well as their family and social dynamics. Active or former substance abusers (N =1,420) were interviewed using a structured questionnaire format. The peak age for substance abuse was between 21 and 30 years and most abusers were male. Leisure, stress and peer pressure were the most common reasons given for abusing substances. There were negative economic and work-related impacts of abusing substances. Risky sexual behaviour may have been a consequenc of abusing substances. Substance abusers need assistance as most of them could benefit from programmes for treatment and rehabilitation. Keywords: substance abuse, Kenya, urban, peri-urba

The challenges of human resources in mental health in Kenya

Objective: Africa faces a skills shortage, in spite of training suitably qualified professionals. This is particularly evident in the discipline of Psychiatry. An analysis of the distribution and availability of psychiatrists in Kenya was thus conducted and findings compared with specific other African countries (Uganda and Zimbabwe). Method: Questionnaire, emailed to Heads of Academic Departments within the specified countries. Results: In 2004, there were a total of 53 psychiatrists practicing in Kenya, for a population of 31.5 million. The country has about 4,000 medical practitioners, with psychiatrists constituting 0.013% of the total number of medical practitioners. This is equivalent to a psychiatrist: population ratio of 1:594,339; doctor: population ratio of 1:7,875; a psychiatrist: overall doctors' ratio of 1:75.5, that is only 1.325% of Kenyan doctors are psychiatrists. When the psychiatrist: population ratios are considered on the basis of the provinces, then the ratios vary from 1:63,007 in the capital city of Nairobi to 1:4,393,19 in other provinces, with one without a psychiatrist for a population of 962,143. The ratios decline further when psychiatrists available for clinical work in public facilities are considered. Up to 34% (n=18) of all Kenyan psychiatrists were in private practice. The remaining 66% (n=35) were in the public sector, of whom more than 20 were in full time administrative or academic positions and therefore not available for full time clinical work in the public sector. Locally trained psychiatrists, compared with foreign trained psychiatrists, fared better on: non-migration to other countries, working in rural rather the urban areas, working in public rather than private sector and in overall academic achievements. Conclusion: In the fore-seeable future in Kenya it will not be possible to achieve a psychiatrist: population ratio equivalent to that in Western countries, both in terms of overall ratio for the country, and more importantly, for the average distribution within the country. For the needs of Kenya, and other developing countries, local training of psychiatrists is superior to foreign training in several parameters. If Kenya and other similar developing countries in Africa are to achieve realistic mental health service delivery in the foreseeable future, alternative non-specialist training in mental health is required. Conflict of Interest: None. This study was conceptualized by DMN. It formed the basis of the Key Note speech at the WHO Regional Conference of Psychiatrists, Arusha, Tanzania 2004. It was funded by the Africa Mental Health Foundation (AMHF). Keywords: Kenya, Questionnaire, Mental health > South African Psychiatry Review Vol. 10 (1) 2007: pp 33-3